Dr. Emad Estemalik, with the Cleveland Clinic, was live on the AccuWeather Network on July 21 to discuss heat, humidity and migraines.

Hot weather, humidity, and changes in barometric pressure are significant triggers for migraine headaches, according to Dr. Imad Estemalek, Director of the Headache Center at the Cleveland Clinic. Migraines are prevalent, affecting roughly 20% of women and 10% of men, and weather is a key factor in their frequency and severity. Dehydration, often caused by increased sweating, outdoor activities, and alcohol consumption in the summer, also plays a major role in triggering migraines.

Dr. Estemalek warns against overuse of migraine medications, as this can lead to rebound headaches or medication overuse headaches, potentially transforming episodic migraines into chronic ones. To prevent migraines during hot weather, he recommends staying hydrated, moderating caffeine intake, avoiding dietary triggers like MSG and nitric oxide, maintaining regular sleep and meal schedules, and taking precautions during extreme weather conditions.

Preventing summer migraine headaches

When temperatures rise, so can your risk for a migraine. Hot weather, humidity, and even changes in barometric pressure can trigger summer migraines. Here to help with some tips is Dr. Imad Estemalek, Director of the Headache Center at the Cleveland Clinic. Thank you so much for being with us. I practiced your name, but I think it still maybe didn't come out perfect, so I apologize for that. No, you said it perfect. Good morning. Thanks for having me. Excellent. Okay, all right, let's start out with how heat, extreme heat, and even the humidity affects the brain and can trigger migraines. So, very good question. And if we want to start by quickly just going over the prevalence of migraines, because really it comes up a lot. So roughly 20% of women have migraines, 10% of men. So you can see how prevalent really it is. And weather tends to be one of the most important factors that can affect migraine frequency, but also bring on migraines for a lot of these patients. So A, so you are correct, the barometric pressure change, if we go really from high temperatures to low or vice versa, it really acts on our sinuses. If you think about our sinuses, they're chambers of air. So anytime that barometric pressure change changes in the external environment, it creates that disequilibrium. And for those who have migraines, they know it right away, it will trigger a bad headache for them. The second being extreme weather, so really extreme heats and extreme colds is another factor that brings it on. And then the third, and that's actually very interesting, we see it with tropical storms or heavy rains, hurricanes. I remember actually doing once an interview when the hurricanes hit in California, because a lot of the media channels were noticing that they were getting a lot of phone calls from patients because of more and more migraines. So it is really those three factors that play a huge role for these patients. How big of a role does dehydration play? Is this one of the more common summer triggers? So dehydration, of course, is very common in the summer, and there are many reasons. A, you're losing a lot of fluid because of increased sweating. Second, we all tend to be outside during these hot weathers. So again, that's another factor for dehydration. And then another thing is, and I mentioned that to a lot of my patients as well, you're enjoying a barbecue, it's very hot, you consume a few alcoholic beverages, and alcohol in general can cause dehydration as well. So you add all those factors together. Dehydration is big when it comes to triggering migraine as well, on top of the weather, of course. All right, so maybe many people think, okay, I'll just take some more of my migraine medication, but how can that end up backfiring? What exactly is a rebound headache? So for those who have migraines, one of the very important concepts to understand is that what we call rebound headaches, or in our terms, MOH, or medication overuse headache, those pain receptors in migraine patients are a little bit different than the average population. All it takes is two to three weeks of an overconsumption, even simply over-the-counter painkillers, and they can get into that rebound, even sometimes in what we call it a status migranosis, where they have a headache that's just not subsiding. And what does it mean to overconsume some of these over-the-counter painkillers? Our number actually is no more than two to three times a week. Once patients get into that four to five, or sometimes daily consumption of over-the-counters, over a period of two to three weeks, they can really end up in a cycle where they're having daily headache, or even transform from what we call having episodic migraine to chronic migraine. And how do we define that? When you have more than 15, 20 headache days a month, you could simply be having two to three, or even sometimes one migraine, you get into that rebound, and you have a complete transformation, which puts you in a very different category of how we approach this from a preventive mechanism. We have one final brief question for you. What can people do to avoid migraines in hot weather? So again, there are many steps you can take. We always talk about modifiable factors and non-modifiable. So things we can modify, of course, is stay hydrated. Caffeine in itself can dehydrate a little bit, but the right amount of caffeine tends to be protective. Really watching their diet during these times. Things that we tell patients about are MSG, nitric oxide, so they know exactly the food we're talking about. Sleep, not skipping meals, and again, the proper hydration is all important. When it comes to weather, of course, we all wanna be outside, we all wanna enjoy it. But those who have migraines, I mean, again, you can't avoid, really, the tropical storms or the rain, but if you notice that an extreme weather is there, and you know that tends to be a trigger for you, I don't think it's unreasonable to take precaution, maybe not be outside if the temperatures are 100 or above. And again, I say that knowing how migraines can really be debilitating for a lot of patients. So again, you take some of these approaches, I think it can really help. Dr. Emad Estemalek, Director of the Headache Center at the Cleveland Clinic. Thank you for all of that information and for joining us here on AccuWeather Early.

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